Journal of evaluation in clinical practice最新文献

{"title":"From Evidence to Bedside: A Qualitative Study of Mindlines in Critical-Care Physiotherapy Practice","authors":"Ritika Panekar,&nbsp;Manish Prannath Shukla,&nbsp;Santosh P. Dobhal","doi":"10.1111/jep.70650","DOIUrl":"https://doi.org/10.1111/jep.70650","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Translating evidence-informed recommendations into routine critical-care physiotherapy remains challenging because clinical decision-making occurs within dynamic and context-dependent environments. The mindlines model provides a conceptual perspective for understanding how clinicians integrate research evidence with experiential, social, and contextual knowledge during everyday practice. However, its application in critical-care physiotherapy remains poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore how physiotherapists working in critical-care units develop and apply mindlines during clinical decision-making and how evidence-informed recommendations are integrated into routine practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative exploratory study was conducted using semi-structured interviews with 22 experienced physiotherapists from diverse critical-care settings. Participants had 5–20 years of ICU experience and were recruited through purposive sampling. Data were analysed using reflexive thematic analysis following an inductive approach, with interpretation informed by the mindlines model. Reporting adhered to the COREQ. 32-item checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five interconnected themes were identified: (1) experience as the primary driver of clinical reasoning, (2) interdisciplinary collaboration shaping decision-making, (3) contextual adaptation of evidence-informed recommendations, (4) time constraints influencing engagement with formal evidence and (5) organisational variation across institutional settings. Participants described integrating research evidence with accumulated clinical experience, multidisciplinary interactions, and contextual factors to support patient-specific decision-making in complex critical-care environments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinical decision-making in critical-care physiotherapy reflects the integration of evidence-informed recommendations with experiential, collaborative, and contextual knowledge through clinicians' mindlines. Recognising these knowledge-translation processes may inform educational, implementation, and organisational strategies that strengthen evidence-informed physiotherapy practice in critical-care settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Economic & Implementation Determinants of Prehospital Stroke Triage Tools: A Systematic Review","authors":"Nadja Alexandrov,&nbsp;Durk-Jouke van der Zee,&nbsp;Maud B. R. C. Eurlings,&nbsp;Maritta N. van Stigt,&nbsp;Monique Theunissen,&nbsp;Erik Buskens,&nbsp;Koen M. van der Waaij,&nbsp;Erik D. Gommer,&nbsp;Jonathan M. Coutinho,&nbsp;Maarten Uyttenboogaart,&nbsp;Maarten M. H. Lahr","doi":"10.1111/jep.70634","DOIUrl":"https://doi.org/10.1111/jep.70634","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Effective prehospital stroke triage enables faster treatment and better patient outcomes. Although prehospital triage innovations are rapidly emerging, evidence regarding the balance between costs and benefits as well as implementation issues remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This review aims to synthesise published evidence on health economics and implementation determinants of prehospital triage tools for acute suspected ischaemic stroke patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic search was conducted across five databases (CINAHL, Cochrane, EMBASE, PubMed, and Web of Science) between 1995 and 2025. Results were reported narratively, and reporting quality was assessed using CHEERS, STROBE-simulation, COREQ, CONSORT, SQUIRE, and GRAMMS. Included were empirical studies of EMS-operated prehospital triage innovations for acute suspected stroke patients. The main outcome measures were health economic outcomes (e.g., ICER) and system-level implementation determinants (CFIR constructs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 6491 screened studies, thirty-one were included: thirteen studies included health economic outcomes and eighteen reported implementation determinants. Prehospital triage tools assessed were: MSU (<i>n</i> = 14), telemedicine (<i>n</i> = 13), clinimetrics (<i>n</i> = 1), prehospital MRI (<i>n</i> = 1), biomarkers (<i>n</i> = 1), and an AI-based microwave tool (<i>n</i> = 1). Most studies (68%) were of high reporting quality. Positive results regarding cost-effectiveness were reported (<i>n</i> = 11), including cost-savings (<i>n</i> = 1), as well as implementation determinants (<i>n</i> = 11). However, evidence on sustained implementation was limited. Barriers included innovation design, complexity, workflow compatibility, work and IT infrastructure, and costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Included studies suggest most prehospital stroke triage tools are cost-effective, but implementation remains largely context-dependent. Barriers, including innovation complexity, role delineation, workflow fit, design, and costs, highlight the need for future studies to integrate health economics into an implementation science framework alongside clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design Principles for Incident Reporting Systems in General Practice: Recurring Recommendations, Rarely Compared-Evidence Mapping and a Proof-of-Concept Deployment in Italy.","authors":"Gianmarco Sirago, Fiorenza Zotti, Filippo Anelli, Francesca Sannino, Michele Abbinante, Alessandro Dell'Erba, Davide Ferorelli","doi":"10.1111/jep.70659","DOIUrl":"https://doi.org/10.1111/jep.70659","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;A small set of design principles-anonymity, simplicity, voluntary participation, timely feedback and a non-punitive culture-is recommended for incident reporting systems in primary care with a consistency that is itself notable. Whether those principles have been tested has attracted far less attention than whether they have been named.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;To establish what evidence supports the design principles conventionally recommended for incident reporting systems in primary care, and to report, as a proof of concept, the deployment of an instrument built on those principles among Italian general practitioners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A two-part study comprising an evidence synthesis followed by an observational pilot. Part 1 was a structured evidence map based on a systematic search of PubMed, Scopus and the Cochrane Library, with backward and forward citation searching of 14 seed publications (PROSPERO CRD420251080728), reported according to PRISMA 2020, with duplicate screening. Each included source was coded against each principle by level of evidence, from not addressed through presupposed, recommended, contested and empirically examined to directly tested, the last requiring the principle to be compared or manipulated and related to a measured reporting outcome. Part 2 was a prospective descriptive deployment of a voluntary web-based reporting instrument among eight general practitioners in Apulia, Southern Italy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 202 sources were included, spanning 1992-2026. Sixteen compare conditions, four of them randomised trials and four with a parallel comparator group. Three sources compare a design characteristic against an alternative and relate the comparison to a measured reporting outcome, and their findings diverge. Confidential reporting yielded more codable reports than anonymous reporting, an observational comparison in which reporters chose the mode. A dictation system produced no significant difference in the number of reports submitted compared with paper, and users preferred paper. A standardised form may slightly increase reporting, an estimate from a single low-certainty study drawn from pharmacovigilance rather than incident reporting. Voluntary participation, timely feedback and a non-punitive culture have not been compared against an alternative in any source. None of them isolates a single design characteristic: two randomised trials intervene on safety culture rather than on the design of the reporting system, and the remainder test multicomponent packages from which no single principle is separable. During the deployment, which ran from February to June 2025, 10 reports were submitted involving 8 practitioners; the number of distinct reporters could not be established. Five of ten concerned aggression towards the practitioner or practice staff and six involved communication failures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;W","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70659"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Adequacy in Endocrine Practice: Reducing Low-Value Care and Advancing Value-Based Medicine.","authors":"Juan J Díez","doi":"10.1111/jep.70687","DOIUrl":"https://doi.org/10.1111/jep.70687","url":null,"abstract":"<p><strong>Purpose: </strong>Low-value care represents a major and under-recognized threat to quality, safety, and sustainability in clinical endocrinology. This review aims to critically examine the role of overdiagnosis and overtreatment as key drivers of low-value care and to identify strategies to support the transition towards value-based endocrine practice.</p><p><strong>Methods: </strong>We conducted a narrative review integrating current evidence on low-value care, overdiagnosis, and overtreatment in endocrinology. We also analyzed major international initiatives (e.g., Choosing Wisely, Right Care) and national programs, with particular focus on the \"do not do\" recommendations developed by the Spanish Society of Endocrinology and Nutrition (SEEN), as well as emerging frameworks from implementation and deimplementation science.</p><p><strong>Results: </strong>Low-value practices are highly prevalent in endocrinology, driven by extensive use of diagnostic testing, evolving disease definitions, and uncertainty in clinical decision-making. These factors contribute to overdiagnosis and overtreatment, often triggering diagnostic-therapeutic cascades that increase patient harm, psychological burden, and healthcare costs without improving clinically meaningful outcomes. Although \"do not do\" recommendations and guideline-based initiatives provide actionable tools, their impact remains limited due to clinical inertia, cultural norms favoring intervention, and systemic barriers to deimplementation.</p><p><strong>Conclusion: </strong>Reducing low-value care is essential to advancing high-quality, patient-centered endocrinology. This requires not only evidence-based recommendations but also transformative changes in clinical culture, clinician behavior, and healthcare systems, ensuring that care consistently maximizes benefit while minimizing harm.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70687"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Are the Implications of Longitudinal Burnout Measurement for Pre-Clerkship Screening and Institutional Support?","authors":"Keshav Banga","doi":"10.1111/jep.70669","DOIUrl":"https://doi.org/10.1111/jep.70669","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70669"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking the Silence: A Mixed-Methods Study of Barriers and Solutions to Incident Reporting in Critical Care Units.","authors":"Mohammed Musaed Al-Jabri, Amina Hemida Salem Ghattas, Marwa Samir Sorour, Amal Diab Ghanem Atalla","doi":"10.1111/jep.70623","DOIUrl":"https://doi.org/10.1111/jep.70623","url":null,"abstract":"<p><strong>Background: </strong>Incident reporting is a cornerstone of patient safety, particularly in critical care settings where patients are highly vulnerable to adverse events. Despite international efforts to promote safety reporting, underreporting persists, especially in low- and middle-income countries. Nurses, as frontline providers, are central to detecting and reporting incidents; however, psychological, organizational, and cultural factors often limit their engagement in reporting processes.</p><p><strong>Aim: </strong>To explore barriers to incident reporting among nurses working in critical care units and identify nurse-informed solutions to strengthen reporting practices and patient safety culture.</p><p><strong>Methods: </strong>A convergent mixed-methods design was employed. A convenience sample of 251 critical care nurses was recruited from eight critical care units of a university hospital. Quantitative data were collected using the researcher-developed Incident Reporting Survey (IRS), which underwent content validation and reliability testing. Descriptive statistics, t-tests, ANOVA, correlation analysis, and multiple linear regression were performed using SPSS version 23. Qualitative data were obtained through two open-ended survey questions and analyzed using Braun and Clarke's thematic analysis framework. Quantitative and qualitative findings were integrated during interpretation through triangulation to generate a comprehensive understanding of reporting barriers and potential solutions.</p><p><strong>Results: </strong>Nurses reported limited awareness of reporting procedures and reluctance to submit reports. Major barriers included fear of blame and punishment, lack of anonymity, heavy workload, inadequate training, and limited managerial support. Qualitative findings reinforced these issues and further highlighted concerns about professional reputation, ineffective feedback mechanisms, and complex reporting systems.</p><p><strong>Conclusion: </strong>Incident reporting remains insufficient due to interconnected individual and organizational barriers. Cultural, educational, and system-level interventions-particularly non-punitive policies and leadership support-are essential to enhance reporting behaviors and strengthen patient safety outcomes.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70623"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Inverted Sign: Rule-In, Rule-Out, and the Epistemology of the Red Flag.","authors":"Albert Grüger","doi":"10.1111/jep.70674","DOIUrl":"https://doi.org/10.1111/jep.70674","url":null,"abstract":"<p><strong>Rationale, aims and objectives: </strong>A validated rule-out instrument can turn the collective absence of warning findings into an explicit warrant for stopping a specified diagnostic inquiry. This paper characterises that inversion in clinical use and asks whether 'red flag' adequately distinguishes it from using positive signs to pursue suspected lesions.</p><p><strong>Method: </strong>Comparative conceptual analysis of the clinical sign, exemplified by Babinski's plantar response, and the Ottawa Subarachnoid Hemorrhage Rule. The Clinical Standards Advisory Group (CSAG) back-pain guidance and SNNOOP10 headache checklist are examined as heterogeneous comparators. Five objections test the argument, including its compatibility with Bayesian reasoning.</p><p><strong>Results: </strong>The inversion concerns intended clinical use and the direction of licensed action, rather than an intrinsic direction of inference determined by sensitivity or specificity. Ottawa provides the paradigm case: within its defined eligible population, absence of all criteria can support foregoing further investigation for subarachnoid haemorrhage. A positive result does not establish the diagnosis, and the composite rule's low specificity does not make every constituent criterion uninformative. Three consequences follow: licensed action can shift from pursuit to stopping; epistemic authority is partly redistributed toward validated thresholds; and negative findings can provide a shared justification for closing a specified diagnostic pathway. Clinical judgement remains necessary throughout. Resource consequences should be distinguished from rationing.</p><p><strong>Conclusions: </strong>The distinctive object is a decision architecture connecting evidence to permission not to investigate. Its limits become clearer when validated rule-out instruments are distinguished from mixed warning checklists and their practical function is separated from their probabilistic properties.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70674"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Umbrella Reviews Establish Consensus in Clinical Practice?","authors":"Thiago P Fernandes, Natanael A Santos","doi":"10.1111/jep.70635","DOIUrl":"10.1111/jep.70635","url":null,"abstract":"<p><p>Evidence-based clinical practice is grounded in research and interpretation of findings. Individual studies capture only part of the evidence relevant to a clinical question, making synthesis important for evaluating consistency and precision. Systematic reviews bring relevant studies together, and meta-analyses use statistical methods to integrate findings. Umbrella reviews emerged to organise and contextualise findings across multiple reviews on a given topic. Convergence across umbrella reviews can support decision-making, but apparent agreement does not necessarily represent independent confirmation when the same primary studies recur across reviews. Substantial overlap can also create apparent disagreement when similar evidence is analysed using different eligibility criteria, outcome selection, or statistical methods. Dependence among included syntheses can persist despite established methods for identifying and managing overlap. The number of concordant syntheses should not be mistaken for the number of independent lines of evidence.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70635"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Average Patient: The Ergodicity Problem in Evidence-Based Medicine and a Proposal for Individual-Dynamic Medicine.","authors":"Utah Hans","doi":"10.1111/jep.70657","DOIUrl":"https://doi.org/10.1111/jep.70657","url":null,"abstract":"<p><strong>Rationale: </strong>Evidence-based medicine (EBM) replaced authority with appraisal and has reduced harm. Its own methodologists have documented a persistent gap between what its methods conclude and what its practice does: average effects that are marginal for most treated patients, guidelines that misfit the individual, widespread difficulty converting relative into absolute effects, and no built-in trigger for stopping a treatment that is not helping.</p><p><strong>Aims and objectives: </strong>To identify a common source of these problems in the application of population-level estimates to individuals, and to propose a framework that corrects it without abandoning controlled evidence.</p><p><strong>Methods: </strong>Conceptual and critical analysis drawing on the methodological critique of EBM published by its founders and leading epidemiologists; the theory of ergodicity in dynamical systems and its empirical tests; the reference class problem; and existing clinical existence proofs of individual-level measurement and closed-loop intervention.</p><p><strong>Results: </strong>The assumption that a population estimate applies to an individual is the ergodic assumption, which holds when a process is homogeneous across persons and stationary over time. Homogeneity fails whenever treatment response differs between people, which is common; where an individual's responses are reproducible, individual-level inference is both necessary and feasible. Large within-person variability weakens every inference and must be measured rather than assumed away. The N-of-1 randomised trial, which estimates an effect in the individual, was published by Guyatt and Sackett in 1986 and ranks at Level 1 of the Oxford 2011 Levels of Evidence, yet a systematic review found 108 published trials in twenty-five years.</p><p><strong>Conclusions: </strong>I propose Individual-Dynamic Medicine, a biocybernetic framework of six principles, each with an existence proof in mainstream medicine, specifying how population evidence and within-person trials divide the work of an individual decision, and state its assumptions, limitations, and the predictions on which it could fail.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70657"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Critical Appraisal of Clinical Practice Guidelines for Asthma Nursing Based on the AGREE II Instrument.","authors":"Yi Hua, Bangyu Zou, Jianan Song, Jie Zhong, Yingying Tang, Yi Zhou, Lijun Zhang","doi":"10.1111/jep.70670","DOIUrl":"https://doi.org/10.1111/jep.70670","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a prevalent chronic respiratory disease affecting approximately 300 million people globally. While numerous CPGs (CPGs) have been released to improve patient quality of life, the methodological quality specifically regarding asthma nursing care remains unclear. This study aimed to assess the methodological quality of CPGs for asthma nursing care published since 2009 using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and to identify factors influencing guideline quality.</p><p><strong>Methods: </strong>Our study was undertaken using PRISMA guidelines. A systematic search was conducted across international and Chinese databases, guideline repositories, and professional association websites to retrieve relevant CPGs on 1 November 2025. Eligible guidelines were evaluated independently by four reviewers using the AGREE II instrument, which includes six domains. Inter-rater reliability was measured via intraclass correlation coefficient (ICC). Subgroup analyses were performed to explore quality differences by publication year, region, version, and number of references.</p><p><strong>Results: </strong>Eleven eligible CPGs were included. The overall ICC was 0.898, indicating excellent inter-rater reliability. Nine (81.8%) guidelines were classified as 'strongly recommended', and two (18.2%) as 'recommended with modifications'. The highest mean scores were observed in clarity of presentation (95.2%), scope and purpose (92.7%), and editorial independence (90.3%), while the lowest was in applicability (69.0%). Notably, only one guideline was specifically tailored for nursing professionals.</p><p><strong>Conclusions: </strong>The overall methodological quality of asthma nursing CPGs is high, but gaps exist in applicability, stakeholder involvement, and rigour of development. Future guidelines should consider regional healthcare disparities, adhere to international development standards, and strengthen nursing-specific content to better support clinical practice and improve patient outcomes.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70670"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}